A Response Modulation Hypothesis of Socioemotional Processing Associated With Alcohol Use Disorder

Alcohol Drinking Related Problems, Alcohol-Related Disorders, Healthy Volunteers

Alcohol, Socioemotional, Functional Magnetic Resonance Imaging (fMRI), Neurofeedback, Drug Relapse

Background: Problem drinking affects nearly half the people who drink alcohol. Drinking alcohol affects a person's social behavior and brain structure, but researchers don't have a good understanding of how. They want to test a technique called neurofeedback to learn more about how to treat problem drinking. Objectives: * To study what happens in the brains of people who drink alcohol when they look at pictures of social things and of alcohol. * To learn if people can control brain activity in a magnetic resonance imaging (MRI) scanner and if this helps people with drinking. Eligibility: * Adults ages 21 to 65 who have an alcohol use disorder. * Healthy volunteers ages 21 to 65 Design: Participants will be screened with * Physical exam * Medical history * Blood, urine, and heart tests * Mental health interview * Questions about their alcohol drinking. At each session, participants will have: * A urine test for drugs and pregnancy. If they test positive, they cannot participate. * A breath alcohol test and assessment for alcohol withdrawal. Participants will complete surveys, talk to researchers about behaviors, and play games. Participants will have MRI brain scans. The scanner is a metal cylinder in a strong magnetic field. They will lie on a table that slides in and out of the scanner for 1-2 hours. Participants will do tasks in the scanner: * They will look at pictures, sometimes of alcohol. * They will try to hit a goal. Some participants will get feedback during this task. They will see how their brain activity changes or how someone else's changes. Participants may have follow-up phone questions at least 3 times over about 6 months.

Study Description: In the first stage, participants will undergo functional magnetic resonance imaging (fMRI) while looking at socioemotional stimuli and alcohol cues and will pilot a neurofeedback training protocol. Personality traits and executive function will also be investigated. This is the pilot stage that will be used to test and refine the neurofeedback parameters and procedure, and to compare neural responses and alcohol attention bias between participants with AUD and healthy controls. In the second stage, inpatient participants with alcohol use disorder will be randomly assigned to receive active or sham neurofeedback. Participants will undergo two functional magnetic resonance imaging sessions including looking at socioemotional stimuli and alcohol cues, resting state fMRI, and real time neurofeedback during alcohol craving. Ability to inhibit attention to alcohol cues and craving will be assessed prior to and following the neurofeedback as well. Participants will be contacted approximately 1 month, 3 months, and 6 months post release from inpatient treatment to assess outcomes. Objectives: The purpose of this protocol is to understand the mechanism whereby neural processes of socioemotional cognition associated with alcohol use disorders lead to negative drinking consequences. This study is a two-stage procedure to both provide evidence of a response modulation deficit associated with socioemotional processing in individuals with alcohol use disorder and investigate how moderating that deficit affects socioemotional processing and negative drinking consequences. Endpoints: Brain engagement during exposure to socioemotional stimuli, alcohol cues, and neurofeedback training (fMRI-scan portion)

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United States